Tuberculous synovitis - knee

Case contributed by Dr Maulik S Patel

Presentation

Left knee - non-traumatic pain, swelling, restricted movements for about 5 months. Difficulty in walking - 2 weeks.

Patient Data

Age: 35 years
Gender: Male
X-ray

Periarticular osteopenia. Supra and infrapatellar soft tissue density. Widened intercondylar notch.

Ultrasound

Diffuse synovial thickening with hypervascularity was seen involving suprapatellar, infrapatellar, medial, lateral joint recesses, and also in posterior joint space.

Collection / granulation was noted extending cranially to a suprapatellar pouch, into muscle.

Lymph nodes are noted in the left iliac - inguinal - popliteal regions.

Case Discussion

Knee arthroscopy was done. Defect was seen in the suprapatellar capsule which explains collection outside joint capsular in the distal thigh.

Synovitis is a non-specific finding. However, extra-articular collection and lymphadenopathy favor infective etiology rather than inflammatory like rheumatoid.

Histopathology - Tuberculosis.

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Case information

rID: 36861
Published: 13th May 2015
Last edited: 24th Apr 2021
Inclusion in quiz mode: Included

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